Prevalence of TB, Hepatitis C, HIV High Among Homeless

Review finds significant heterogeneity in prevalence estimates between different studies

MONDAY, Aug. 20 (HealthDay News) -- The global prevalence of tuberculosis, hepatitis C virus infection, and HIV is high among homeless people, although significant heterogeneity is seen in prevalence estimates, according to a study published online Aug. 20 in The Lancet Infectious Diseases.

In an effort to estimate the prevalence of tuberculosis, hepatitis C virus infection, and HIV among homeless people, Ulla Beijer, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues conducted a systematic review and identified 43 surveys involving a population of 59,736 homeless individuals.

The researchers found that there was significant heterogeneity in prevalence estimates, with prevalences ranging from 0.2 to 7.7 percent for tuberculosis, 3.9 to 36.2 percent for hepatitis C virus infection, and 0.3 to 21.1 percent for HIV infection; prevalence ratios ranged from 34 to 452, 4 to 70, and 1 to 77, respectively. The prevalence of tuberculosis was higher for studies that used chest radiography for diagnosis, compared with other methods, and in countries with a higher general population prevalence. Newer studies had lower HIV prevalence than older studies, and HIV infection prevalence was higher in the United States versus the rest of the world.

"The risks of epidemics of infectious diseases in homeless populations remain significantly higher than those in the general population in the same country," writes the author of an accompanying editorial. "These increased risks are a public health challenge for the population as a whole. Implementation of specific strategies to [reduce] these risks is crucial."